Methods and Devices for Evaluating and Treating a Bone Condition based on X-Ray Image Analysis

1. A method of treating a bone condition comprising (a) obtaining an image from a subject; (b) analyzing, using a computer system, the image obtained in step (a) to derive quantitative information on bone structure, wherein the quantitative information is obtained from a sliding region of interest (ROI) on the image; (c) diagnosing a bone condition based on the analysis of step (b); and (d) selecting and administering a suitable treatment to said subject based on said diagnosis.

2. The method of claim 1 , further comprising the step of comparing the information with information in a database of bone structure measurements obtained from selected subjects.

3. The method of claim 1 , wherein the treatment comprises administering one or more antiresorptive agents.

4. The method of claim 1 , wherein the treatment comprises administering one or more anabolic agents.

5. The method of claim 3 , wherein the treatment further comprises administering one or more anabolic agents.

6. A method of determining bone mineral density from an x-ray image in a computer system, the method comprising the steps of (a) determining density of one or more internal standards in said image; (b) creating a weighted mean between the values obtained in step (a); and (c) utilizing said weighted mean to determine bone mineral density of bone in a sliding ROI in said image.

7. The method of claim 6 , wherein the internal references are selected from the group consisting of air, fat, water, metal and combinations thereof.

8. A method of determining bone structure from an x-ray image in a computer system comprising the steps of (a) identifying one or more internal standards on said x-ray image; (b) determining the density or structure of said one or more standards; and (c) utilizing the density, structure or combinations thereof of said one or more standards to determine bone structure in a sliding ROI in the x-ray image.

9. The method of claim 8 , wherein said internal standard is selected from the group consisting of a tooth, a portion of a tooth, cortical bone, air, subcutaneous fat, and muscle.

10. A method of evaluating, using a computer system, bone disease in a subject, the method comprising the steps of: (a) obtaining an x-ray image from said subject, wherein said image includes one or more bones; (b) assessing bone mineral density in at least one sliding ROI of said image; (c) assessing bone structure in said sliding ROI; and (d) combining said assessments of bone mineral density and bone structure to evaluate bone disease.

11. The method of claim 10 , wherein said bone disease comprises the risk of bone fracture or the risk of osteoporotic fracture.

12. The method of claim 10 , wherein said evaluation comprises diagnosing bone disease.

13. The method of claim 10 , wherein said evaluation comprises monitoring the progression of bone disease.

14. The method of claim 10 , further comprising selecting a therapy based on the evaluation of bone disease and administering said therapy to said subject.

15. The method of claim 14 , wherein said evaluation comprises monitoring the progression of bone disease during or after administration of said selected therapy.

16. The method of claim 10 , further comprising the step of assessing one or more macro-anatomical parameters in said image and combining said assessment of bone mineral density, bone structure and macro-anatomical parameters to diagnose bone disease.

17. A method of treating bone disease in a subject, the method comprising the steps of: (a) obtaining an image from said subject, wherein said image includes one or more bones; (b) assessing, using a computer system, bone mineral density in at least one sliding ROI of said image; (c) assessing bone structure in said sliding ROI; (d) combining said assessments of bone mineral density and bone structure to evaluate bone disease; (e) selecting a therapy based on the evaluation of bone disease; and (f) administering said therapy to said subject.

18. The method of claim 17 , wherein steps (a) to (d) are repeated.

19. The method of claim 17 , wherein steps (a) to (e) are repeated.

20. A method for evaluating, using a computer system, bone disease in a subject, the method comprising the steps of: (a) obtaining an image of said subject wherein said image includes one or more bones; (b) assessing bone structure of said bone in a sliding ROI in said image; (c) assessing one or more macro-anatomical parameters in said image; and (d) combining the assessments bone structure and macro-anatomical parameter assessment to evaluate bone disease.

21. The method of claim 20 , wherein said bone disease comprises the risk of bone fracture.

22. The method of claim 21 , wherein said fracture is osteoporotic fracture.

23. The method of claim 20 , wherein said evaluation comprises diagnosing bone disease.

24. The method of claim 20 , wherein said evaluation comprises monitoring the progression of bone disease.

25. The method of claim 24 , wherein the monitoring comprises repeating steps (a) to (d) at two or more time points.

26. The method of claim 20 , further comprising selecting a therapy based on the evaluation of bone disease and administering said therapy to said subject.

27. The method of claim 26 , wherein said evaluation comprises monitoring the progression of bone disease during or after administration of said selected therapy.